In 1941, an Australian ophthalmologist by the name of Norman Gregg noted a mini-epidemic of a rare eye disorder (“congenital cataract”) in newborn infants referred to him for treatment. Intrigued, he went looking for a cause. What he discovered astonished him – and the rest of the medical profession. It turned out that most of the mothers of these unfortunate infants had contracted Rubella (“German Measles”) during their first trimester of pregnancy. Rubella infection in adults is generally no big deal; symptoms are “flu-like,” and self-limited in duration. Gregg’s observations led to the realization that rubella – a mild disorder for the pregnant mother – could be devastating to her fetus. Other infectious agents capable of causing severe fetal damage were soon added to the list. (In Med School I was taught the acronym “TORCH” – standing for Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes – as a way of remembering these agents.) Read the rest of this entry »

I have just finished reading NeuroTribes – The Legacy of Autism and the Future of Neurodiversity, by Steve Silberman. It is a worthy read.

I spent most of my career as a developmental pediatrician in academic medical centers, surrounded by trainees. And for the last 10 years, when I was in private practice, I extended myself to several of the nearby universities (PENN, where I held two teaching appointments, Villanova, PCOM, and others), with the object of having a trainee (nurse, physician, social worker, other) with me in the office, looking over my shoulder, at all times. The trainees always thanked me. My response was always: “It is I who am in debt to you. You are bright, observant, and inquisitive. What’s more, you haven’t reached that stage in your own professional development who you have begun to sort information into 2 categories: ‘Received Wisdom, Never to be Challenged,’ and ‘Everything Else.’ Because you do not come at the subject with this handicap, you have the refreshing habit of asking questions in novel ways, or forcing me to explain things that I generally tend to take for granted.” Silberman brings the same outsider’s eye to the subject of ASD. Read the rest of this entry »